Healthcare Provider Details

I. General information

NPI: 1841079415
Provider Name (Legal Business Name): ARGYLE PEDIATRIC DENTISTRY PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/25/2023
Last Update Date: 12/27/2024
Certification Date: 12/19/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8131 GATEWAY DRIVE SUITE 700
ARGYLE TX
76226
US

IV. Provider business mailing address

8131 GATEWAY DRIVE SUITE 700
ARGYLE TX
76226
US

V. Phone/Fax

Practice location:
  • Phone: 503-270-7319
  • Fax:
Mailing address:
  • Phone: 503-270-7319
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223P0221X
TaxonomyPediatric Dentistry
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QD0000X
TaxonomyDental Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. VISHAL P PANCHMATIA
Title or Position: OWNER
Credential: DMD
Phone: 503-270-7319